Abstract

Cognitive deficits such as attentional impairment and executive dysfunction significantly impact daily living activities in older adults with dementia. This study aimed to evaluate the efficacy of Cognitive Stimulation Therapy (CST) compared to Reality Orientation & Reminiscence Therapy (RO&RM) in improving attention, episodic memory, and executive functions in older Chinese adults with mild to moderate dementia. Additionally, it sought to explore the relationship between attention improvements and changes in executive functions. A retrospective observational pre–post study was conducted from September 2018 to July 2021, involving 160 participants aged 65 or above, diagnosed with dementia. Participants were divided into CST (n = 80) and RO&RM (n = 80) groups, receiving six weeks of daily 1-h sessions. Attention and episodic memory were assessed using the Kendrick Cognitive Test for the Elderly (KCTE), and executive functions were evaluated using the Chinese Disability Assessment for Dementia (CDAD). CST significantly improved attention (p = 0.002) and episodic memory (p = 0.010), with attention improvements being more pronounced. RO&RM showed no significant improvement in these areas. Overall, executive functions did not significantly change, but a positive correlation was found between improved attention and reduced decline in executive functions. CST demonstrated notable potential in enhancing attentional capacities and episodic memory in older Chinese adults with dementia. However, its impact on executive functions was inconsistent. Future research should involve larger sample sizes, longer follow-up periods, and explore combining CST with other therapies to maximise therapeutic potential. This study underscores the importance of culturally adapting CST to better fit the needs of the Chinese dementia population.